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Suggest Pain Management Treatment For Streptococcal Infection In The Spine

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Posted on Mon, 27 Mar 2017
Question: My mother had a strep B infection that developed in here C1-2 spine in Dec. 2015. She was in the hospital for 2 weeks, rehab for 3 weeks and home on IV antibiotics for two months followed by 1 month of oral antibiotics. She had horrible pain for a long time. She seemed to be getting better over 2-3 months following all the antibiotics and was getting some physical therapy when she fell and hit her head. Her neck painreturned and has been getting worse. The pain used to be on the left side and is now concentrated on the right side. Recently she began to have swelling of the area. She has revisited her neurosurgeon and her infectious disease doctor. They have performed testing and do not think she has a reoccurrence of infection. She is known to have non-surgical DDD in the cervical spine per the neurosurgeon. They sent her pain management her gave her temporal nerve blocks as well as a epidural injection at C7 with little to no relief. We have recently taken her to a different pain management doctor that can go higher in the spine with a catheter but he is concerned about waking up dormant bacteria. She is diabetic and has heart disease. He thinks that the pain is coming from outside the spinal column. He decided to give her a topical compound cream which has done very little. She is 79 years old and remains with a pain level of about a 9 on a 1-10 scale. We are at our not sure where to go from here. Can you please give me some direction. She can barely move her neck and the pain level is staying to high. She has had several MRI's and it shows bone edema. Do we need a CT of the neck, myelogram, bone scan, etc. I am at a loss. Her primary doctor does not have a clue and does not really act she wants to be involved in this due to the complexity. Any suggestions would be of help. Thanks, XXXXXXX
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Answered by Dr. Dr. Monika Dede (2 hours later)
Brief Answer:
Please see the detailed answer below.

Detailed Answer:
Hello! I have been through your question.
Related your concern I think that the recent situation, based on the above mentioned data and her clinical history, now is not related to the strep B infection.Even that bone (cervical) infection is difficult to treat, I think that after a full course treatment over 3 months of antibiotics as your mother has done,and after negative result retesting, the pain is not related to the infection but with the trauma.You said that she have non-surgical DDD in the cervical spine as per the neurosurgeon and after several MRI result shows bone edema that I think is due to the trauma.
Yes is very difficult to treat the pain in your mother because her prior infection history, her age and heart diseases and diabetes.
What I suggest for your mother is to do a bone scan for the moment and to follow by a neurologist or orthopedist for the recent situation( bone edema after trauma).
It is known that bone scans image both the structure and the active cell growth of the bones, so are often used in conjunction with other imaging like MRI.They are often used as a follow-up test when the cause of your pain or symptoms needs to be clarified.
I hope my answer helps you.
I wish your mother a quick recovery.
Above answer was peer-reviewed by : Dr. Remy Koshy
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Answered by
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Dr. Dr. Monika Dede

Infectious Diseases Specialist

Practicing since :2003

Answered : 1005 Questions

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Suggest Pain Management Treatment For Streptococcal Infection In The Spine

Brief Answer: Please see the detailed answer below. Detailed Answer: Hello! I have been through your question. Related your concern I think that the recent situation, based on the above mentioned data and her clinical history, now is not related to the strep B infection.Even that bone (cervical) infection is difficult to treat, I think that after a full course treatment over 3 months of antibiotics as your mother has done,and after negative result retesting, the pain is not related to the infection but with the trauma.You said that she have non-surgical DDD in the cervical spine as per the neurosurgeon and after several MRI result shows bone edema that I think is due to the trauma. Yes is very difficult to treat the pain in your mother because her prior infection history, her age and heart diseases and diabetes. What I suggest for your mother is to do a bone scan for the moment and to follow by a neurologist or orthopedist for the recent situation( bone edema after trauma). It is known that bone scans image both the structure and the active cell growth of the bones, so are often used in conjunction with other imaging like MRI.They are often used as a follow-up test when the cause of your pain or symptoms needs to be clarified. I hope my answer helps you. I wish your mother a quick recovery.